A novel 14-day, non-opioid, postsurgical pain treatment known as NeuroRelease is being developed by PixarBio Corporation and is expected to be FDA approved in 2018, according to the company. The non-addictive agent can be locally injected around peripheral nerves, facet joints, nerve roots, or muscles during surgery to eliminate the need for opioids after surgery, according to the company.It affects sensory pain fibers without affecting motor control.The product combines a concentrated amount of carbamazepine and the FDA-approved polymer poly(lactic-co-glycolic acid) or PLGA.

"The agent has microparticles that degrade over time allowing controlled, sustained local release of carbamazepine," said Amer Khalil, MD, who is Medical Director and a member of the Scientific Advisory Board at PixarBio. Carbamazepine currently is indicated for the treatment of pain associated with trigeminal neuralgia and for the treatment of epilepsy.

Because carbamazepine is a selectively acting analgesic rather than a local anesthetic, it affects sensory pain fibers without affecting motor control. Thus, patients treated with NeuroRelease could wake up from surgery pain free and with early ambulation, allowing for quick entry into physical therapy and a shorter recovery time, said Dr. Khalil.

Using spine surgery as an example, Dr. Khalil explained that NeuroRelease would be injected during surgery around the facet joints, nerve roots, and/or paraspinal muscles to prevent postsurgical pain and muscle spasm. This treatment would avoid the need for opioid analgesics.

While the agent is being engineered for 2 weeks of pain relief following surgery, NeuroRelease can be engineered to extend pain relief up to 6 months after a single injection, said Dr. Khalil, who also is Director of Spine Surgery and Assistant Professor of Neurological Surgery at the Department of Neurological Surgery at the University of California, Irvine.

Thus, different applications of NeuroRelease may be useful in a number of pain conditions, including chronic pain syndromes. Clinical studies are expected to begin in mid-2017 and involve patients undergoing spine surgery, knee replacement, hip replacement, shoulder surgery, and Cesarean section.